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Dear Mr. Manners: My husband seems to be suffering from erectile dysfunction but I don’t really know how to broach the topic – or even if I should. What’s the best thing to do or say? Help, please! – A lonely wife

A: First of all, know that your husband is hardly alone; millions and millions of American men are affected by what’s called erectile dysfunction (ED), not to mention the less direct effects this condition can have on spouses, like you. So, I’m glad you reached out – especially because all the TV advertisements for ED could lead you to think that popping a pill is the simple answer to fire up your tiger’s tiger.

As you may know, ED is an honest-to-god-real-life medical condition, defined by the inability to achieve or sustain an erection long enough for sexual intercourse. It can be brought about by depression, stress, anxiety or aging. However, its most frequent cause is undiagnosed conditions like high cholesterol, diabetes, even early heart disease -- as well as the medications often used to combat these ailments (notably high blood pressure drugs). I tell you this for two reasons: Why should there be such a stigma for a medical condition? And second, many women tend to see impotence as a sexual or relationship issue, blaming themselves if not their partners. That’s not so helpful.

To get to the heart of the matter, I talked with Dr. Laura Berman, a sex educator and relationship therapist, about your concerns, and she explained how quickly things can spiral out of control if the blame game rears its ugly face. Explained Dr. Berman: “Once ED occurs, the man can start to become very anxious about it happening again. Ironically, this can make ED more likely to occur, and it can also complicate his relationship with his partner…. Meanwhile, his partner might have no idea what’s going on and be very concerned and even angry.”

So, what to do (and not to do):

Don’t be afraid to talk with each other: Silence or avoidance won’t make the condition any better and it will likely harm your relationship. “Communication is key,” says Dr. Berman, adding that it’s better to find a non-sexual time and place to talk. Do your best to be open – not critical or judgmental. If your fellow isn’t ready to join the conversation, let him be, although Dr. Berman says it’s a good idea to see if he’ll talk with his doctor (especially to rule out any physiological causes and to get a proper diagnosis) or just do some reading (which you can make handy).

Be supportive: When I asked my Facebook followers for their advice on your question, nearly all of them voiced some variant of this: “Be patient, and let him know you still love the heck out of him.” An ED sufferer added: “Do not get frustrated with your partner because of it, just be understanding.” A wife of someone with ED told me: “Reassure him that he is beautiful and that you love him.” What not to do: Don’t make a big deal of it, criticize him or freak out.

Don’t be afraid to experiment: Sex isn’t just about penetration. As another spouse whose partner has been diagnosed with erectile dysfunction put it: “There are tons of other body parts to enjoy, not to mention toys when needed.” In other words, show your husband that your relationship is not focused around his ability to have an erection.

No jokes, no quips, please: All too often we say the wrong thing when we’re anxious or uncomfortable. Keep a lid on it! As Dr. Berman suggests: “Don’t make insults about it, even in a joking way, and never bring it up around your family or friends.” What’s private stays private.

For the guys let me add this: Disclose your condition only if and when you’re ready. There’s no rule about when to talk to a partner other than deciding for yourself when you’re comfortable. (The same is true regarding the use of any medication to combat it.) Dr. Berman adds: “Men don’t have to wear their ED like a scarlet letter. Think about it this way: Women don’t reveal whether they have heavy periods or difficulty reaching orgasm before sex – unless they choose to.”

Finally, let me also add that when I talk about manners in general, I’m a zealot for kindness and respect; in discussing sexual manners, I can’t emphasize those same two qualities enough.

If some kind of sexual dysfunction has plagued your relationship, how have you handled it as a couple? Please discuss in the comment section below.

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Every Thursday, Steven Petrow, the author of five etiquette books, and the forthcoming “Mind Your Digital Manners,” addresses questions about medical manners.

Important: The views and opinions expressed in this article are those of the author and not Everyday Health. See More

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